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SIR 2025

Embolization

Scientific Session

Session: Pain Management 1

Clinical Efficacy of Genicular Artery Embolization for Knee Osteoarthritis: A Systematic Review and Meta-Analysis

Monday, March 31, 2025
3:27 PM – 3:36 PM CT
Location: Music City Center, 207 AB
Purpose: The purpose of this study is to evaluate the efficacy of genicular artery embolization (GAE) for knee pain related to osteoarthritis (OA).

Materials and Methods: A comprehensive systematic search was conducted on MEDLINE (PubMed), Embase, Cochrane (CENTRAL), Scopus, and Web of Science, after which studies were screened based on pre-specified eligibility criteria. Studies reporting pain scores assessed by the Visual Analog Scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Knee Injury and Osteoarthritis Outcome Score (KOOS) were pooled. OpenMeta[Analyst] was used to pool VAS scores at 1, 3, 6, and 12 months using a random effects model. Standardized mean differences (SMD) with corresponding 95% confidence intervals (CI) were calculated as measures of effect size for WOMAC and KOOS. To address heterogeneity, subgroup analyses based on OA severity and embolic type were conducted for both VAS and SMD scores. Additionally, meta-regression was performed for SMD scores, considering variables such as the percentage of female patients, knees treated, sample size, and baseline mean pain. This systematic review and meta-analysis followed PRISMA guidelines {1}.

Results: Overall, 18 studies, including a total of 575 patients and 606 treated knees, were included. Patients who underwent GAE demonstrated a significant decline in VAS pain scores at 1 month (−33.667 points [95% CI: 29.46, 37.86]), 3 months (−34.058 points [95% CI: 28.95, 39.15]), 6 months (−33.077 points [95% CI: 25.40, 40.75]), and 12 months (−34.089 points [95% CI: 23.73, 44.44]), all with p-values < 0.001. The SMD for WOMAC and KOOS from baseline to 6 and 12 months was −0.232 [95% CI: −1.88, 1.41]; p = 0.78 and −0.130 [95% CI: −2.60, 2.34]; p = 0.91, respectively. Subgroup analysis and meta-regression for SMD scores were not significant.

Conclusion: GAE is a minimally invasive therapeutic approach that provides significant pain reduction for patients with mild, moderate, and severe refractory knee OA at both short- and long-term follow-ups. This innovative procedure has the potential to establish itself as the standard of care before pursuing surgical interventions. Further randomized controlled trials with longer follow-up periods are recommended to validate the efficacy and safety of GAE in managing knee OA.